ABSTRACT #49

Implementing An Educational Orientation Curriculum For The Medical Genetics Residency Program

Sivan Lewis, Cassie Mintz

PURPOSE AND GOALS: Medical Genetics residency is a 2-year program whose trainees are either in a combined Pediatrics/Genetics or Medicine/Genetics track or have completed at least 2 years of Pediatrics, Ob-Gyn or Medicine residency. This diversity may lead to differences in genetics knowledge. Previously, no lectures were included in orientation, and a Medical Genetics course would take place mid-year. Genetics is a rapidly evolving field and trainees are expected to counsel families and educate team members on complex testing. Therefore, providing them with core concepts in orientation is essential for optimal patient care. Our goal was to assess residents’ confidence in basic skills and improve orientation accordingly.

METHODS: We reviewed the Medical Genetics course curriculum to generate topics all trainees should be familiar with. A survey assessing confidence in related patient care activities was sent to trainees and graduates to account for prior orientation formats. Results were used to create an educational curriculum in consultation with program leadership.

Senior residents and genetic counselors taught the new curriculum in the 2022 orientation. Surveys were sent to evaluate improvement at least 2 months after beginning clinical work.

EVALUATION PLAN: Surveys were emailed to fellows and alumni. Questions included trainee background, materials available at orientation, and confidence in performing genetics-specific patient care activities during the first 2 months of training on a scale of 1 (=Very Uncomfortable) to 5 (= Very Comfortable).

SUMMARY OF RESULTS: Surveys were completed by 5 trainees and 5 graduates; 20% categorical-Ob/ Gyn, 20% categorical-Peds, 30% combined Genetics/Peds, 10% combined Genetics/IM, 20% unanswered. Over 80% received an orientation handbook and chief resident overview. No educational content was reported aside from pedigree workshop in 30%. The following clinical skills had ≥60% of respondents rating a confidence level of 1-2: performing a dysmorphology exam, ordering cytogenetic tests, ordering molecular tests and interpreting biochemical test results. After the new curriculum was given in July 2022, a repeat survey was completed by 3 incoming trainees. All responders reported a confidence level of 2-3 in dysmorphology exam, 3 in ordering cytogenetic tests and 3 in ordering molecular tests. Interpreting biochemical test results showed variation between 1-3.

REFLECTIVE CRITIQUE:

The orientation curriculum successfully addressed and improved residents’ reported confidence in areas of deficiency noted on the initial survey. Due to the small size of our program, we have limited data, however, we plan to continue to assess the success of our orientation and consider implementing further improvements, for example, to improve confidence in interpreting biochemical tests. It is worth noting that the planned dysmorphology lecture could not be added to orientation due to timing and was addressed via a longitudinal lecture series so the improvement in confidence is related to that educational experience.